Re: Buyer beware, be very, very aware when it comes to dubious VAC disability application withdrawals by VAC ...

by Hwthrn Mon 16 Jan 2023, 12:32

I currently have a claim in as-well for occipital neuralgia for the past 1.5 years, if you don’t mind me asking what kind of disability percentage did you get for it?

by Unknown Soldier Sat 13 Mar 2021, 13:45

Rubicon wrote:Interestingly enough the decision letter makes no mention of what was discussed with the VAC employee on the telephone last week. Not one reference. The reason now mentioned in the letter refers to the date of the original diagnosis which was in November 2015 which is older than the VAC two year requirement from a physician. Interestingly, the first application for Cervical Angina consequential to Degenerative Disk Disease (DDD) was September 2015 and that application was suspended because someone at VAC decided Cervical Angina as well as my Occipital Neuralgia (severe headaches) were both similar in nature and thus already covered under my DDD approved disability. Thus, both consequential disability applications were SUSPENDED by VAC as a result. BPA was engaged and a Medical Review Board date was set in Peterborough. Just one month prior to that Review Board date BPA advised me that VAC had changed their application adjudication process and there would be a good chance of getting a disability approval the second time around. I chose to apply for the Occipital Neuralgia first and it was approved after a two year wait in November 2020. This put me over the 100 percentile for compensation. I then applied for Cervical Angina a second time in November 2020 only to have it WITHDRAWN owing to the above-mentioned excuse. I am now awaiting word from BPA on how to proceed. Getting an up-to-date cardiologist report is no issue which I will readily do if advised to do so. The principal here however is this application has been suspended once and now withdrawn once for "irregular" and unsubstantiated reasons by VAC. I advised both VAC and BPA of my intention to appeal via the following secure e-mail via My VAC Account. I will update this post as conditions warrant and BPA has been engaged.

"In response to the denial letter I received this morning I am shocked that the 6 November 2015 cardiologist report is now the excuse used to deny my disability application owing to its age. The report date was never discussed with (name withheld) at the VAC office in (location withheld) when he phoned me to discuss my application. In fact, the initial application for Cervical Angina was dated 16 September 2015. It was suspended by VAC owing to an excuse of both Cervical Angina and Occipital Neuralgia being clumped under the umbrella of Degenerative Disk Disease which was an approved disability. In discussion with BPA this decision was challenged and at the last minute prior to my Medical Review Board, BPA advised me it would be more favourable to reapply thru VAC once again because adjudication methods had become more favourable for the veteran. I applied for Occipital Neuralgia first and it was approved in November 2020 after a two year waiting period. It was then that I reapplied for Cervical Angina only to find out VAC wishes to change the rules once again and deny me treatment for my condition which is well documented with a specialist as consequential to DDD. The VAC "delay, deny and hope they die" tactic will not work this time. The 2015 cardiologist report is old because of VAC's outdated prolonged adjudication methods which make reports seem old when in fact the issue is not the report at all. I have sent a similar message to BPA because I feel they bare some responsibility for this mess."

Rubicon

VAC spends more time trying to figure out an angle to deny a veteran s claim than reading the medical documents sent in by specialists confirming the injury is real.

by pinger Fri 12 Mar 2021, 22:47

Hello everyone, been a while since I visited. Nice to see familiar folks.
Sounds like some things have not changed with VAC, just the acronyms.
"Cervical Angina which is well documented with a specialist as consequential to DDD."
Rubicon, consequential claims are a brutal bureaucracy.
The shyte I went though 5 10 years back.. Nuts.
But in the end I persevered. Approved for my consequential DDD TOD lower leg function..
Mind you, I'm still not at 100%....
TeenTitan I agree.
"VAC is categorizing applications now to control the narrative of applications in backlog for veterans"
That's an old trick, but the dynamics of PR sure aren't these days. Spin and Optics.
Stay safe all. pinger

by Rubicon Mon 15 Feb 2021, 18:27

Interestingly enough the decision letter makes no mention of what was discussed with the VAC employee on the telephone last week. Not one reference. The reason now mentioned in the letter refers to the date of the original diagnosis which was in November 2015 which is older than the VAC two year requirement from a physician. Interestingly, the first application for Cervical Angina consequential to Degenerative Disk Disease (DDD) was September 2015 and that application was suspended because someone at VAC decided Cervical Angina as well as my Occipital Neuralgia (severe headaches) were both similar in nature and thus already covered under my DDD approved disability. Thus, both consequential disability applications were SUSPENDED by VAC as a result. BPA was engaged and a Medical Review Board date was set in Peterborough. Just one month prior to that Review Board date BPA advised me that VAC had changed their application adjudication process and there would be a good chance of getting a disability approval the second time around. I chose to apply for the Occipital Neuralgia first and it was approved after a two year wait in November 2020. This put me over the 100 percentile for compensation. I then applied for Cervical Angina a second time in November 2020 only to have it WITHDRAWN owing to the above-mentioned excuse. I am now awaiting word from BPA on how to proceed. Getting an up-to-date cardiologist report is no issue which I will readily do if advised to do so. The principal here however is this application has been suspended once and now withdrawn once for "irregular" and unsubstantiated reasons by VAC. I advised both VAC and BPA of my intention to appeal via the following secure e-mail via My VAC Account. I will update this post as conditions warrant and BPA has been engaged.

"In response to the denial letter I received this morning I am shocked that the 6 November 2015 cardiologist report is now the excuse used to deny my disability application owing to its age. The report date was never discussed with (name withheld) at the VAC office in (location withheld) when he phoned me to discuss my application. In fact, the initial application for Cervical Angina was dated 16 September 2015. It was suspended by VAC owing to an excuse of both Cervical Angina and Occipital Neuralgia being clumped under the umbrella of Degenerative Disk Disease which was an approved disability. In discussion with BPA this decision was challenged and at the last minute prior to my Medical Review Board, BPA advised me it would be more favourable to reapply thru VAC once again because adjudication methods had become more favourable for the veteran. I applied for Occipital Neuralgia first and it was approved in November 2020 after a two year waiting period. It was then that I reapplied for Cervical Angina only to find out VAC wishes to change the rules once again and deny me treatment for my condition which is well documented with a specialist as consequential to DDD. The VAC "delay, deny and hope they die" tactic will not work this time. The 2015 cardiologist report is old because of VAC's outdated prolonged adjudication methods which make reports seem old when in fact the issue is not the report at all. I have sent a similar message to BPA because I feel they bare some responsibility for this mess."

Rubicon

by **Teentitan** Fri 12 Feb 2021, 11:00

Just a point here I think should be taken into consideration.

VAC over the last 4/5 months has slowly been dropping info about the backlog. One of the statements caught my attention and I dug into it with the news reporter who told the story. There is only 21,000 claims in the backlog. The rest are either uncompleted applications by the vet or doctor. Wrong info submitted. Pending medical reports etc, etc.

VAC is categorizing applications now to control the narrative of applications in backlog for veterans.

To double down on this and buy time a report was released last month that VAC employees feel abused or are working in a caustic atmosphere.

Rubicon IMO your application was categorized. If I were to guess you went into the "Maxed out" category so your application was pulled. But like you said too many VAC employees do not understand we veterans need the injuries noted to receive medical treatment. Make sure you save that email from your My VAC account and any letters you get from VAC. I suggest everyone start doing this now.

by Bigbrook Fri 12 Feb 2021, 10:18

I had a similar experience with a CLAIM DENIAL. I had 31 years of service and have multiple back issues. My claim was denied for my latest condition for 2 reasons. 1) there was no mention of my new condition on my enrollment medical.... DAH! and 2.) There was no mention of this condition on my release medical. My medical records have numerous entries identifying back injuries and the condition that was denied was a definite consequential condition related to the already awarded disabilities. I am sure that this application was denied by a rookie adjudicator who can read words but can not think outside the lines and make a logical decision. I have resubmitted the application through the Bureau of Pension Advocates but I expect it will now go to the bottom of the pile again.

by Rubicon Thu 11 Feb 2021, 20:12

It has recently come to my attention that VAC may be trying to diminish their backlog of outstanding disability applications by outright withdrawing them with bullshit (bogus) excuses thus reducing their backlog numbers. This just occurred with my most recent disability application to which I immediately replied via My VAC Account secure e-mail. (see below) The pissing contest continues:

"While I have yet to receive a decision letter on subject disability application and may never because the claim has been withdrawn by VAC; it is my intention to appeal the decision to withdraw the claim. I believe an error has occurred in adjudicating the validity of my disability application. While my disabilities already total 100 percent, as discussed yesterday with (name withheld) at VAC in (location withheld), I am seeking treatment for the condition of Cervical Angina which is determined to be consequential to my Degenerative Disk Disease (DDD). I do not agree with (name withheld's) assessment that Cervical Angina and DDD are one and the same and I am certain that my cardiologist and neurologist would agree with me as well as a medical review board. I am not seeking financial compensation because there is none once 100 percent compensation has been reached. If for nothing more than clarification for Blue Cross treatment purposes for my Service Providers; I am requesting a decision on my disability application for Cervical Angina consequential to Degenerative Disk Disease. Maxing out at 100 percent disability is not a valid rationale for VAC to withdraw my application when this application is solely about treatment at this point. The same goes for any future disability applications should conditions arise."

The individual that called me from VAC appeared to be "new" owing to the lack of familiarity with a consequential disability condition supported by a cardiologist report and referenced speaking to their supervisor before and after the telephone call to me. Rest assured, even though a veteran may reach 100 percent with multiple approved conditions, there is still treatment to be had regardless of financial compensation. Blue Cross will NOT approve treatment for any condition unless it is in the approved column. This individual was not familiar with Blue Cross billing and the more they talked the more I knew they weren't. Something told me to throw this out there to the community to see if anyone else has experienced a VAC disability application withdrawal. No benefit of the doubt was applied in my case owing to a lack of corporate knowledge by a newby. Rest assured a veteran has the right to have their disability application adjudicated. No application should be withdrawn by VAC without a valid excuse. I am awaiting their written response now that I have advised them that I am appealing the withdrawal. I will update this topic if and when I hear from VAC.

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Buyer beware, be very, very aware when it comes to dubious VAC disability application withdrawals by VAC ...